@layout("/common/_container.html"){
<div class="ibox float-e-margins">
    <div class="ibox-content">
        <div class="form-horizontal"  id="reNewInfoForm">

            <input type="hidden" id="id" value="${item.id}">
            <input name="formToken" type="hidden" value="${session.formToken}" />
            <div class="row">
                <div class="col-sm-6">
                    <#select id="insuranceId" name="保险公司" underline="true" >
                    @for(insurance in insurances!){
                    <option value="${insurance.id}">${insurance.insuranceAbbr}</option>
                    @}
                    </#select>
                    <#input id="effectiveDate" name="生效日期" underline="true" type="text"  value="${defaultDay}"/>
                </div>

                <div class="col-sm-6">
                    <#input id="policyCode" name="保单号" underline="true" maxlength="30"/>
                    <#input id="invalidDate" name="失效日期" underline="true" type="text"/>
                </div>
            </div>

            <div class="row btn-group-m-t">
                <div class="col-sm-12" style="text-align: center;">
                    <#button btnCss="info" name="提交" id="ensure" icon="fa-check" clickFun="ReNewInfoDlg.addSubmit()"/>
                    <#button btnCss="danger" name="取消" id="cancel" icon="fa-eraser" clickFun="ReNewInfoDlg.close()"/>
                </div>
            </div>
        </div>

    </div>
</div>
<script src="${ctxPath}/static/modular/system/policy/re_new.js"></script>
<script>
    laydate.render({
        elem: '#effectiveDate'
    });
    laydate.render({
        elem: '#invalidDate'
    });
</script>
@}
